Individual
CHARISSE REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1347
(917) 547-0497
Mailing address
2031 CHATTERTON AVE, BRONX, NY 10472-6105
(917) 547-0497
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026927-01
NY
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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